Online learning meets Health Service requirements

Taking training online is nothing new to the health service. It has been nearly 15 years since the reams of clinical information that once populated vast bookshelves in NHS learner libraries were annotated and placed conveniently online for easy, cross-organisational access at a click of the mouse. With so many learning materials online, NHS staff have increasingly taken ownership of their own professional development and training.
However, in the last few years it is fair to say that the NHS has well and truly said goodbye to the days when online learning constituted clinicians downloading PDF worksheets from a central CPD database. Web 2.0 and the ensuing interactivity that characterises this new generation of activity has meant that today’s online learning programmes move well beyond an online resource centre. Organisations are now using virtual learning platforms to deliver whole accreditation programmes and vital skills training. And they are doing it at lower cost than traditional classroom-based approaches, across multiple locations.
In the NHS today online learning means that professional qualifications can be delivered with over half of tuition completed online, and learning management systems make it possible for those responsible for talent and development to monitor employees’ progress and ensure all learners are progressing through their required tuition.

As the NHS enters the era of more for less, the development of sophisticated next generation learning systems, which blend on and offline approaches, could not have come at a better time. In general terms, these platforms will be essential to delivering necessary training in cash-strapped trusts – and getting as many staff as possible engaged with both mandatory and optional professional development training.
More specifically, as trusts work to comply with the World Class Commissioning standards, blended learning is making it possible to deliver high impact leadership and commercial acumen training internally, at a price point that would be simply unrealistic if using traditional classroom-based approaches.
Finally, as more cases are revealed of inadequately trained locums and temporary clinical staff putting patients lives at risk, NHS trusts need more robust systems to manage and monitor staff screening and induction programmes. Moving inductions online is a strong first step toward making initial staff training more efficient, while substantially reducing the risk of unskilled clinical staff walking the wards and putting patient safety at risk.
With Andrew Lansley’s promise to cut costs in the NHS through either a hiring freeze or real headcount reductions, training and retaining top employees will become even more critical for trusts to achieve more for less and deliver top quality patient care. When headcount is tight, ensuring future success falls squarely on the shoulders of those responsible for internal talent development, who must identify, train and retain those level staff with the potential to lead their trusts in five, ten, or fifteen years.

Delivering high impact leadership programmes to band 2-4 staff carries high cost and resource implications, however. Hence, over the last few years many trusts have struggled to find consistent, effective training programmes to offer lower management tiers basic leadership skills, internal coaching techniques, and management and resource planning.
Blended learning can overcome this problem and help trusts deliver leadership training en masse. The Lancashire Care NHS Foundation Trust uses a blended learning system to deliver the Institute of Leadership and Management’s fully accredited blended learning programmes.
The online platform has successfully provided flexible learning to Lancashire Trust’s emerging managers, who are spread over up to 100 locations across the county. The programme combines online courses with classroom based learning, enabling NHS managers to study in their own time, with close and continuous peer support and online tuition from an ILM-qualified trainer.
There are advantages to this approach for both the middle managers themselves and Lancashire’s HR staff responsible for talent management. With such geographically disparate staff, the online leadership solution means the Trust’s HR and organisational development teams can directly check the progress of any of their learners at any time. The ability to monitor staff across all locations ensures there is equal engagement in the training, and that no one is being left behind. Within each ILM module, learners are encouraged to progress at their own pace, and to interact with their fellow managers online.

Human contact is still an essential element of CPD, particularly for leadership training, which is why all Lancashire learners have access to classroom-based sessions with professional coaches and mentors. When face-to-face classes are needed, what would traditionally have been a morning session is cut to just an hour. Because theory can be covered beforehand online, the face-to-face learning focuses on real-life examples, case studies, role play, and other types of practical training.
Chris Field, the management development advisor from Lancashire Care Trust, encourages other trusts to future-proof their middle managers by investing in leadership training now. Using the internet to develop a blended learning platform to deliver ILM qualifications allows trusts to invest in their future leaders, even in the midst of major belt-tightening.
Chris comments: “As an organisation we are spread throughout Lancashire, and using the blended learning approach has given us the ability to support individuals in their work place and for the tutors to bring mixed groups of staff together at key points of the programme. Trusts have access to Joint Investment Funding for this type of leadership development programme and, given the huge benefits to the Trust we have seen, it is a great way to provide fully funded training for band 2-4 management staff.”

The World Class Commissioning (WCC) initiative has put responsibility for commercial awareness firmly in the hands of individual trusts. And while for the first time in a generation trusts have significant purchasing power and decision-making flexibility, they are also taking on major new responsibilities.  
As just one element of the multi-faceted WCC, staff training risks falling to the wayside as trusts work tirelessly to achieve compliance. The irony here is that in preparing for WCC compliance, trusts may sideline the very skills training which could support compliance.
The Assurance for Competence programme requires that trusts compare their staff skills and competencies against a best practice framework. Because the process can be time-intensive for individual trusts, leveraging technology to offer online skills assessment can make it easy to identify in which skill sets and competency area individual trusts are falling short of the national standard.
Web 2.0 inspired online assessment tools are currently being developed to help trust talent managers analyse and review their staffs’ competencies online. These tools will allow HR and talent management directors to directly compare their staffs’ skills and knowledge against the Assurance for Competence requirements within WCC policy.
Once trusts have identified where knowledge gaps exist, blended learning can then deploy trust-specific learning and reference material necessary to bring staff in line with WCC standards. For instance, in our experience, commercial awareness is often one of the major skill sets trusts initially struggle to bring into line with WCC best practice. Using online learning platforms, trust managers can first identify the specific elements of commercial acumen lacking amongst its senior leaders, and then provide trust-specific online resources and tuition to bring leaders up to speed with the Department of Health’s recommended approach to procurement, resourcing, efficiency savings, and other commercially-minded skill sets.
The WCC was conceived in order to help the NHS run more efficiently and achieve more for less. This represents an institutional step change for many trusts, and proper commercial training is simply an acknowledgment of the major cultural shift that the health service is now asking of its staff. Interactive, user-friendly tools that allow individual trusts to deploy tailored training programmes to help employees meet national best practice are critical to widespread WCC compliance and to really reap the benefits of the WCC approach.

Trusts that rely on locums and other temporary clinical staff to deliver patient care face a constant flux of incoming talent, all of whom need lengthy and time-intensive inductions, not to mention a robust screening process to ensure they are fit to practice. For locum-reliant trusts, such robust induction processes can become both expensive and unwieldy.
This is a third area where new blended learning technology is having a major impact on patient care, while simultaneously reducing the HR team’s workload and increasing the quality of the employee screening along the way. Online screening, testing and inductions will not just save lives, but also hold the promise of saving resources. New employee inductions are a vital, if somewhat formulaic, tool of the HR function. Getting staff on board with the NHS ethos and working practice is critical to maintaining service levels. In the health service, these inductions should always be paired with necessary skills screening, which test locums and other clinical staff for required language skills and applicable clinical competencies.
The current system remains largely paper-based and relies on individual HR managers to identify necessary screening procedures for each new employee. In practice it can lead to inconsistency in how the screening is applied, leaving trusts open to incompetent or under-trained locums on the ward floor.
With some NHS trusts experiencing annual staff turnover of up to 12 per cent, the volume of new employees in need of induction and screening can create an unnecessary burden on HR staff resulting in inconsistently administered inductions. To avoid this, trusts should capitalise on new technology to bring the entire induction process online. Rather than running decentralised, departmental induction programmes, blended approaches streamline a trust’s induction process, meaning all new employees receive an auto-generated check-list of induction and screening requirements, based on their NHS band and the work they will be responsible for in the trust.
For clinical leads who regularly employ short-term locums and other temporary staff, online induction processes can be integrated into the agency’s screening process, meaning new staff will have completed their necessary competencies tests and basic induction activities before even clocking in for their first day’s work.  
The States of Jersey Health Department, which experiences high staff turnover due to location, is considering plans to launch a fully blended online Induction Academy. The scalable system will give instant access to screening and induction material relevant to each new member of staff, from across the whole of the trust’s administrative and clinical functions, alongside standard organisational information and directives, ultimately saving on recruitment and induction costs.
With a user-friendly interface, the trust and new locums themselves will be able to access a list of outstanding screening tests and inductions specific to their role. The system will not allow employees to enter the workplace until these assessments have been successfully completed, going a long way towards eliminating the human error typically to blame when incompetent clinical staff are allowed to practice.


NHS trusts face a fundamental challenge: transforming themselves into lean, competitive, and patient-centric organisations that will be able to deliver world-class care under increasingly tight funding streams. Effective, interactive blended learning solutions can play a huge part in effectively managing this transition.
Whether the goal is to build staffs’ commercial awareness, reduce risks through robust locum induction, or to deliver leadership qualifications to middle managers, blended learning is increasingly the platform of choice. Interactivity, real-time access, personalisation, and flexibility all separate modern blended learning programmes from the cumbersome, static online libraries of the past. As the NHS looks to achieve more for less, blended learning will be critical to maintaining positive staff engagement and organisational momentum.

John Baxter is the head of public sector learning and development at LSN, the experts in learning and skills provision.